Measurements And Significance Of Plasma Leptin Concentration In Congestive Heart Failure

Objective: To observe the alteration of plasma leptin, insulin and TNF- a in patients with congestive heart failure (CHF), and to assess the relation between plasma leptin and insulin resistance in CHF. Methods:1 Several biochemical parameters were measured, including fasting glucose, triglyceride and total cholesterol, et al. Body mas index, WHR, %Fat, left ventricular ejection fraction and E/A were estimated.2 The level of fasting plasma leptin was examined by means of adioimmunoassay. the level of fasting plasma insulin and TNF- a were examined by means of chemiluninescence immunoassay. Insulin resistance was determined using HOMA index (HOMA-IR=FPGX FINS/22.5) .3 The correlation between plasma leptin and age, BMI, WHR, %Fat, TG, TC, HDL, FPG, FINS, TNF- a were analyzed. Homa insulin resistance index was regarded as dependent variable, and age, BMI, WHR, %Fat, serum total cholesterol, triglyceride, high density lipoprotein, palsma TNF- a and leptin were regarded as independent variables. Multiple stepwise regression was performed to study the influencing factor of insulin resistance. Results:1 Plasma Leptin of patients with NYHA grade III and NYHA grade IV were significantly higher than that with NYHA grade II.2 Plasma leptin was not different between patients with NYHA grade III and NYHA grade IV . Plasma TNF- a were elevated in patients with CHF when compared with those in control subjects (p<0.01). More specifically, their levels wereprogressively elevated with severity of CHF deteriorated and there were significant differences in subgroups of NYHA II-IV(p<0.01) .3 Plasma insulin was related positively to plasma leptin (r=0.598, p<0.01) and BMI, WHR, %Fat were also related positively to plasma leptin. The multiple stepwise regression suggested that HOMA-IR was positively associated wth plasma leptin and TNF-a .Conclusion:1 Plasma leptin level is raised in patients with CHF. plasma leptin of patients with NYHA grade III and NYHA grade IV are significantly higher than that with NYHA grade II. There are not different between patients with NYHA grade III and NYHA grade IV .2 Plasma leptin is related positively to plasma insulin BMI, WHR, %Fat. Plasma insulin may increases the release of leptin.3 Plasma leptin and TNF- a may are involved in insulin resistance.